Water Handling and Osmo-regulation- Al Jaber

Question 1

total body weight=

Answer 1

wt (kg) x 0.6

Question 2

normal osmolality range

Answer 2

280-300

Question 3

blood - RBC’s

Answer 3

plasma

Question 4

plasma - clotting factors

Answer 4

serum

Question 5

total concentration of all particles in solution

Answer 5

osmolality

Question 6

contributes 97-98% of total osmolality

Answer 6

Na+

Question 7

concentration of only the osmotically active particles

Answer 7

tonicity

Question 8

contributes to tonicity in ECF

Answer 8

Na+

Question 9

contributes to tonicity in ICF

Answer 9

K+

Question 10

____maintains osmotic equilibrium by responding to changes in solute concentrations

Answer 10

water

Question 11

caused by an excess amount of water in system and therefore decreases Na+ concentration

Answer 11

hyponatremia

Question 12

1-2% change in plasma osmolality causes ______handling

Answer 12

water

Question 13

what percent of filtrate reaches collecting duct

Answer 13

10%

Question 14

out of 180L/day filtered, what reaches collecting duct

Answer 14

18L

Question 15

minimum urine osmolality concentration

Answer 15

50

Question 16

approximate plasma osmolarity concentration

Answer 16

280-300

Question 17

____ cannot make pure water

Answer 17

kidneys

Question 18

what causes changes in cell volume

Answer 18

tonicity

Question 19

what are equal partners in determining tonicity of urine

Answer 19

Na+ and K+

Question 20

negative electrolyte free water clearance number

Answer 20

pt not capable of secreting water in the urine

Question 21

positive electrolyte free water clearance number

Answer 21

how much water will be excreted in the urine APPROPRIATE response from kidney in state of too much water

Question 22

2 main steps for the concentration of urine in reaction to body water loss:

Answer 22

1. medullary interstitial hyperosmolarity formed
2. water from tubule to interstitium

Question 23

thick ascending tubule adds what to interstitium

Answer 23

NaCl

Question 24

thin tubules hold what in interstitium

Answer 24

NaCl

Question 25

adds urea to interstitium

Answer 25

collecting tubule

Question 26

allows for passive movement of water into interstitium through aquaporins

Answer 26

collecting duct

Question 27

water flows into interstitium; NaCl flows into lumen (osmolarity increases)

Answer 27

thin descending limb

Question 28

water impermeable; NaCl leaves lumen into interstitium (osmolarity decreases)

Answer 28

ascending limb

Question 29

allows for medullary environment to be highly concentrated so able to reclaim water when needed

Answer 29

urea

Question 30

hormone used to reclaim more water

Answer 30

ADH

Question 31

what inserts aquaporins in CD and allows water to passively move from urine to interstitium b/c of concentrated medullary interstitium

Answer 31

ADH

Question 32

urine output and concentration of urine in someone who is very dehydrated

Answer 32

low urine output and high urine concentration (water taken out of urine)

Question 33

marker for ADH presence

Answer 33

urine osmolarity

Question 34

if urine is diluted, what does that mean for ADH presence

Answer 34

not present

Question 35

has no role in concentration process of urine

Answer 35

PCT

Question 36

takes NaCl and adds to interstitial environment (step in hypertonic medullary environment)

Answer 36

thick ascending limb

Question 37

continues to dilute urine by taking NaCl into blood

Answer 37

DCT

Question 38

lack of ADH production

Answer 38

central diabetes insipidus

Question 39

failure of CD to respond to ADH

Answer 39

nephrogenic Diabetes insipidus

Question 40

too much urine produced

Answer 40

polyuria

Question 41

does not participate in urine dilution process

Answer 41

PCT

Question 42

NaCl into interstitium

Answer 42

thick ascending limb

Question 43

no ADH so no passive flow of water here

Answer 43

Collecting duct

Question 44

secretion of ADH despite having excess body water and decreased body fluid osmolarity

Answer 44

syndrome of inappropriate diuresis

Question 45

SSRIs (anti-depressants) main cause of this

Answer 45

syndrome of inappropriate diuresis

Question 46

patient has hyponatremia, low plasma osmolarity; urine not being appropriately diluted due to excess production of ADH

Answer 46

syndrome of inappropriate diuresis